Policy decision-making about coverage] is a complex process with profound implications for beneficiaries'access to medical treatments and new health technologies. Ultimately, [coverage decisions about health programs or policies] require an estimate of the 'true'effectiveness of a given health care intervention, which should be based on sound scientific evidence, which is frequently lacking. Nevertheless, complex judgements about the relative benefits and harms of coverage decisions need to be made. There is a critical need for a well-defined transparent and ideally unified and widely applicable system for [coverage decision-making]. Specific Aims: The overarching goal of the proposed conference is to develop a rational framework for [coverage decision-making], which is acceptable to all major stakeholders. The specific aims of this workshop are to discuss the application of GRADE to [coverage decisions]. Previous Work: The GRADE Working Group has previously developed a methodologically rigorous yet practical and transparent system to develop clinical practice guidelines that has been formally endorsed by over 55 organizations. The development of GRADE to date has been by an iterative process of generating ideas based on prior experience and empirical (methodological) evidence, testing these out by applying them to diverse examples, reaching a consensus of the individuals at a particular meeting, input from people not at a meeting and follow-up discussion at subsequent meetings, thereby serving as the model for this proposal. Plan for Workshop and Expected Products: We request funding to support a two-day workshop to be attended by select GRADE members as well as representatives of key stakeholder organizations responsible for health policy decision-making. Expected products: 1) the workshop will engage key stakeholder organizations involved in [coverage decision-making] in the adaptation and application of GRADE 2) [define how GRADE evidence profiles should be adapted to best suit the information needs of people making coverage decisions 3) develop a framework on how to move from evidence to coverage decisions, analogous to the GRADE framework for making judgments about clinical recommendations 4) develop and disseminate guidance documents on the use of GRADE for decisions about coverage]. PUBLIC HEALTH RELEVANCE: [Health policy decisions about coverage represent complex judgments about the balance of the expected benefits and harms that should ideally be made using a methodologically rigorous and transparent system.] The GRADE Working Group has previously developed a methodologically rigorous, transparent yet practical approach to rating the quality of evidence and strengths of recommendations for clinical practice guideline development that is applicable to [decision- making about coverage]. The proposed workshop will engage key stakeholder organizations to develop a rational and unified framework for [policy decision-making about coverage].